Alzheimer's Disease: Should I Take Medicines?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Your options

Treat Alzheimer's disease with medicines for as long as they
are helpful.

Don't take medicines. Try other ways to improve thinking and
memory and to reduce confusion.

Key points to remember

Medicines can't cure
Alzheimer's disease, but they can slow it down for a
while and make it easier to live with. They may relieve symptoms such as having
trouble thinking and remembering things.

Medicines may not work
for everyone. Even if they do work, they may not make a big difference in how
you think and remember.

Medicines may cost a lot. You can try
taking them for a while to see if they help and if that help is worth the cost
to you.

These medicines have side effects, but many people are
able to take them without problems. Side effects can include nausea, diarrhea,
vomiting, belly pain, weight loss, and lack of hunger.

Some people
with Alzheimer's disease are able to keep up their daily activities for many
years, even if they do them at a reduced level or in different ways. If you
decide not to take medicine, you can help yourself by scaling back on
activities to match your abilities. You can also try scheduling activities
during the times of day when you can best handle them.

Alzheimer's disease damages the
brain. It causes a steady loss of memory and affects
how well you can speak, think, and do your daily activities.

Alzheimer's disease always gets worse over time, but how quickly this
happens varies. Some people lose their ability to do daily activities early on.
Others may do fairly well until much later in the disease. As the disease gets
worse, you may:

Have trouble making decisions.

Be confused about what time and day it is.

Get lost in places you
know well.

Have trouble learning and remembering new
information.

Have trouble finding the right words to say what you
want to say.

Have more trouble doing daily tasks like cooking a
meal or paying bills.

Medicines can't cure
Alzheimer's disease. But they can slow down the way it
affects your brain and make the disease easier to live with.

Cholinesterase inhibitors are
the most commonly used medicines for Alzheimer's. They can boost memory and the
ability to do daily activities. They can be used in all stages of the disease.

Memantine (Namenda) can relieve
symptoms of memory loss, confusion, and thinking problems. It may help you in
the middle and late stages of the disease, when your symptoms are severe. You
may take this medicine alone or with cholinesterase inhibitors.

Other medicines may be used to help with anxiety,
agitation, anger, or other symptoms like these.

Medicines may not
work for everyone. Even if they do work, they may not make a big difference in
how you think and remember. Over time, as your disease gets worse, medicines
will stop working. The long-term effects of these medicines are not known.

If you have been diagnosed with
Alzheimer's disease, you may feel angry, frightened,
depressed, and worried about the future. Even though
the disease gets worse over time, some people are able to keep up their daily
activities for many years, even if they do them at a reduced level or in
different ways.

Try some of these ways to cope, with or without
medicines:

Scale back on
activities to match your abilities. A task may take longer than it used to, but
if you want to keep doing it, you should try. Make changes as needed. For
example, if you no longer feel comfortable cooking, think about other things
you can do, such as shopping and meal planning or setting the table. Or try
using simpler recipes.

Schedule activities
and tasks for the times of day when you're best able to handle them. It may
help to have a routine that doesn't change much from day to day.

You or your caregivercan help
avoid confusion at home by labeling often-used rooms
and objects.

Before you go out alone, write
down where you are going, how to get there, and how to get back home. Do this
even if it's a place you have gone many times before. Take someone else along
when you can.

Personal stories about taking medicines for Alzheimer's disease

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

As long as
I'm doing all right, I would like to stay off of medicines. Some days it's
really hard, because I get confused and even frightened. But I don't tolerate
medicines that upset my stomach very well, and I'd like to stay feeling as
well as I can until my disease progresses. My wife knows to put me on
medicines if I become violent or if my behaviors become burdensome to her.

Jed, age
62

I was just diagnosed as being in the early
stages of Alzheimer's disease. I'd like to remain as mentally clear as I
possibly can for as long as I can. I'm going to try taking a cholinesterase
inhibitor called Aricept, because it may help delay the this condition
for a few more months. Even though that's not a long time, every day is
precious to me.

MaryAnne, age 74

My wife, Sally, left instructions that she
would like to be put on medicines if her personality changes and memory loss
become a burden for me. Her memory loss and thinking problems have become
severe, so her doctor has prescribed a new type of medicine called memantine
that might reduce these symptoms. Even though no medicine will prevent the
disease from progressing, I want to keep my Sally with me for as long as I can.

Joel, age
81

Fred, who is 77, is in the later stages of
Alzheimer's disease. He was taking cholinesterase inhibitors and then memantine
for several years with good results. But his body is no longer responding
to the medicines. He is incontinent, and the medicines give him diarrhea.
My sons and I have decided it's time to take Fred off the medicines and let
the disease run its course.

Harrietta, age 73

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicines to treat Alzheimer's disease

Reasons not to take medicines

I want to keep doing my daily activities as long as I can, even if it means taking medicines.

I want to keep doing my daily activities without relying on medicines.

More important

Equally important

More important

I think taking medicines will help me stay independent longer.

I don't think taking medicines will make a difference in how independent I am.

More important

Equally important

More important

The cost of the medicines doesn't bother me.

I'm worried about the cost of the medicines.

More important

Equally important

More important

I can deal with the side effects of these medicines.

I'm worried about the side effects.

More important

Equally important

More important

Even though medicines may not work for me, I still want to try them.

I don't want to try medicines if they aren't going to work.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking medicines

NOT taking medicines

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

Do medicines make a big difference for everyone with Alzheimer's disease who takes them?

YesSorry, that's not right. Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.

NoYou're right. Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.

I'm not sureIt may help to go back and read "What medicines are used to treat Alzheimer's disease?" Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.

2.

Can medicines cure Alzheimer's disease?

YesNo, that's not right. There is no cure for Alzheimer's disease. But medicines can slow it down for a while and make it easier to live with. They may relieve symptoms such as having trouble thinking and remembering things.

NoYou're right. There is no cure for Alzheimer's disease, but medicines can slow it down for a while and make it easier to live with. They may relieve symptoms such as having trouble thinking and remembering things.

I'm not sureIt may help to go back and read, "What medicines are used to treat Alzheimer's disease?" There is no cure for Alzheimer's disease, but medicines can slow it down for a while and make it easier to live with.

3.

Do most people who take medicines have problems with side effects?

YesSorry, that's not right. These medicines have side effects, but most people are able to take them without problems.

NoYou're right. These medicines have side effects, but most people are able to take them without problems.

I'm not sureIt may help to go back and read the section "What are the side effects of these medicines?" These medicines have side effects, but most people are able to take them without problems.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Alzheimer's Disease: Should I Take Medicines?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the facts

Your options

Treat Alzheimer's disease with medicines for as long as they
are helpful.

Don't take medicines. Try other ways to improve thinking and
memory and to reduce confusion.

Key points to remember

Medicines can't cure
Alzheimer's disease, but they can slow it down for a
while and make it easier to live with. They may relieve symptoms such as having
trouble thinking and remembering things.

Medicines may not work
for everyone. Even if they do work, they may not make a big difference in how
you think and remember.

Medicines may cost a lot. You can try
taking them for a while to see if they help and if that help is worth the cost
to you.

These medicines have side effects, but many people are
able to take them without problems. Side effects can include nausea, diarrhea,
vomiting, belly pain, weight loss, and lack of hunger.

Some people
with Alzheimer's disease are able to keep up their daily activities for many
years, even if they do them at a reduced level or in different ways. If you
decide not to take medicine, you can help yourself by scaling back on
activities to match your abilities. You can also try scheduling activities
during the times of day when you can best handle them.

FAQs

What is Alzheimer's disease?

Alzheimer's disease damages the
brain . It causes a steady loss of memory and affects
how well you can speak, think, and do your daily activities.

Alzheimer's disease always gets worse over time, but how quickly this
happens varies. Some people lose their ability to do daily activities early on.
Others may do fairly well until much later in the disease. As the disease gets
worse, you may:

Have trouble making decisions.

Be confused about what time and day it is.

Get lost in places you
know well.

Have trouble learning and remembering new
information.

Have trouble finding the right words to say what you
want to say.

Have more trouble doing daily tasks like cooking a
meal or paying bills.

What medicines are used to treat Alzheimer's disease?

Medicines can't cure
Alzheimer's disease. But they can slow down the way it
affects your brain and make the disease easier to live with.

Cholinesterase inhibitors are
the most commonly used medicines for Alzheimer's. They can boost memory and the
ability to do daily activities. They can be used in all stages of the disease.

Memantine (Namenda) can relieve
symptoms of memory loss, confusion, and thinking problems. It may help you in
the middle and late stages of the disease, when your symptoms are severe. You
may take this medicine alone or with cholinesterase inhibitors.

Other medicines may be used to help with anxiety,
agitation, anger, or other symptoms like these.

Medicines may not
work for everyone. Even if they do work, they may not make a big difference in
how you think and remember. Over time, as your disease gets worse, medicines
will stop working. The long-term effects of these medicines are not known.

What are the side effects of these medicines?

Most
people are able to take these medicines without problems. Most side effects go
away within a few weeks after you start taking the medicines.

The
most common side effects of cholinesterase inhibitors
are:

Nausea (feeling sick to your
stomach).

Diarrhea.

Vomiting.

Upset stomach
(indigestion).

Belly pain.

Lack of
hunger.

Weight loss.

Other problems are less common. You may feel very tired,
have trouble sleeping, or have muscle cramps.

Common
side effects of memantine are:

Dizziness.

Confusion.

Headache.

Trouble moving your bowels
(constipation).

It's important to have regular visits with your doctor
while you are taking these medicines. As the disease gets worse and symptoms
change, your medicines or doses may change too.

If you are caring
for someone with Alzheimer's disease, watch for problems or side effects from
medicines.

What can you do to help yourself without taking medicines?

If you have been diagnosed with
Alzheimer's disease, you may feel angry, frightened,
depressed, and worried about the future. Even though
the disease gets worse over time, some people are able to keep up their daily
activities for many years, even if they do them at a reduced level or in
different ways.

Try some of these ways to cope, with or without
medicines:

Scale back on
activities to match your abilities. A task may take longer than it used to, but
if you want to keep doing it, you should try. Make changes as needed. For
example, if you no longer feel comfortable cooking, think about other things
you can do, such as shopping and meal planning or setting the table. Or try
using simpler recipes.

Schedule activities
and tasks for the times of day when you're best able to handle them. It may
help to have a routine that doesn't change much from day to day.

You or your caregivercan help
avoid confusion at home by labeling often-used rooms
and objects.

Before you go out alone, write
down where you are going, how to get there, and how to get back home. Do this
even if it's a place you have gone many times before. Take someone else along
when you can.

Why might your doctor recommend medicines?

Your
doctor may recommend that you take medicines for Alzheimer's if:

Medicines will make it easier for you to do
daily activities.

Medicines will reduce your symptoms and make it
easier for others to take care of you.

2. Compare your options

Take medicines for
Alzheimer's disease

Don't take medicines

What is usually involved?

You take pills every day for as
long as they help your symptoms.

You see your doctor regularly to check how well the medicines are
working. As the disease gets worse, you may want to try a different medicine,
dose, or combination of medicines.

You or your caregiver can
try other ways to
reduce confusion, such as labeling often-used rooms
and objects.

You can try other ways to cope with the disease, such
as scaling back on tasks to match your abilities.

What are the benefits?

Your memory and ability to think
clearly may get better for a short time.

Medicines may slow down
the effects of the disease. You may be able to stay independent longer.

You avoid the cost and side
effects of medicines.

If you are not able to cope on your own, you can try medicines
later.

What are the risks and side effects?

Medicines may not
help everyone who has Alzheimer's disease.

Medicines can't cure the
disease. Over time, medicines will stop working.

Medicines can cost
a lot.

Side effects include:

Diarrhea.

Vomiting.

Upset
stomach.

Belly pain.

Lack of hunger.

Weight
loss.

You may not
be able to cope with your symptoms without medicines.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about taking medicines for Alzheimer's disease

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"As long as I'm doing all right, I would like to stay off of medicines. Some days it's really hard, because I get confused and even frightened. But I don't tolerate medicines that upset my stomach very well, and I'd like to stay feeling as well as I can until my disease progresses. My wife knows to put me on medicines if I become violent or if my behaviors become burdensome to her."

— Jed, age
62

"I was just diagnosed as being in the early stages of Alzheimer's disease. I'd like to remain as mentally clear as I possibly can for as long as I can. I'm going to try taking a cholinesterase inhibitor called Aricept, because it may help delay the this condition for a few more months. Even though that's not a long time, every day is precious to me."

— MaryAnne, age 74

"My wife, Sally, left instructions that she would like to be put on medicines if her personality changes and memory loss become a burden for me. Her memory loss and thinking problems have become severe, so her doctor has prescribed a new type of medicine called memantine that might reduce these symptoms. Even though no medicine will prevent the disease from progressing, I want to keep my Sally with me for as long as I can."

— Joel, age
81

"Fred, who is 77, is in the later stages of Alzheimer's disease. He was taking cholinesterase inhibitors and then memantine for several years with good results. But his body is no longer responding to the medicines. He is incontinent, and the medicines give him diarrhea. My sons and I have decided it's time to take Fred off the medicines and let the disease run its course."

— Harrietta, age 73

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicines to treat Alzheimer's disease

Reasons not to take medicines

I want to keep doing my daily activities as long as I can, even if it means taking medicines.

I want to keep doing my daily activities without relying on medicines.

More important

Equally important

More important

I think taking medicines will help me stay independent longer.

I don't think taking medicines will make a difference in how independent I am.

More important

Equally important

More important

The cost of the medicines doesn't bother me.

I'm worried about the cost of the medicines.

More important

Equally important

More important

I can deal with the side effects of these medicines.

I'm worried about the side effects.

More important

Equally important

More important

Even though medicines may not work for me, I still want to try them.

I don't want to try medicines if they aren't going to work.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking medicines

NOT taking medicines

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Do medicines make a big difference for everyone with Alzheimer's disease who takes them?

Yes

No

I'm not sure

You're right. Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.

2.
Can medicines cure Alzheimer's disease?

Yes

No

I'm not sure

You're right. There is no cure for Alzheimer's disease, but medicines can slow it down for a while and make it easier to live with. They may relieve symptoms such as having trouble thinking and remembering things.

3.
Do most people who take medicines have problems with side effects?

Yes

No

I'm not sure

You're right. These medicines have side effects, but most people are able to take them without problems.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

3.
Use the following space to list questions, concerns, and next steps.

Credits

By

Healthwise Staff

Primary Medical Reviewer

Anne C. Poinier, MD - Internal Medicine

Specialist Medical Reviewer

Peter J. Whitehouse, MD - Neurology

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